Outpatient Registered Nurse - RN

Fresenius Medical Care•Ashland, KY

About The Position

The Outpatient Registered Nurse works as part of a hemodialysis health care team to provide quality daily care in accordance with company policies, procedures, training, and applicable regulations. The nurse supports the company's mission, values, quality programs, compliance requirements, and continuous improvement activities. The position oversees and coordinates patient care delivered by direct-care staff, assesses patient needs, delegates tasks, monitors staff practices, and contributes to staff training and orientation. The nurse educates patients and families about end-stage renal disease, dialysis treatment, vascular access, diet, fluids, medications, laboratory results, treatment adequacy, transplant awareness, and treatment options. The nurse provides and monitors hemodialysis care, evaluates patient responses, implements prescribed treatment plans, addresses access and adequacy concerns, and communicates with physicians and other members of the care team. Responsibilities also include maintaining accurate patient records and treatment documentation, managing laboratory orders and specimens, administering medications and transfusions as prescribed, maintaining emergency readiness, and ensuring a clean, safe treatment environment. The nurse participates in quality improvement, completes required assessments and care plans, and may provide coverage at any or all area facilities as required by management.

Requirements

Graduate of an accredited School of Nursing.
Current appropriate state licensure and ability to meet practice requirements in the state of employment.
Successfully complete a training course in the theory and practice of hemodialysis.
Successfully complete CPR certification.
Meet the necessary requirements of the Ishihara Color Blindness test as a condition of employment; failure does not preclude employment, and reasonable accommodation may be considered.
Meet appropriate state requirements, if any.
Provide coverage at any or all area facilities as required by management.
Complete ICD-9 coding training.
Complete Nurses Technical Training.

Nice To Haves

Minimum of one year of medical-surgical nursing experience preferred.
Hemodialysis experience preferred.
ICU experience preferred.

Responsibilities

Direct and monitor Patient Care Technicians and other direct patient care staff in the safe and effective delivery of chronic hemodialysis therapy.
Delegate tasks, assess daily patient care needs, and develop appropriate patient care assignments.
Monitor staff techniques and adherence to facility policies and procedures; participate in staff training, orientation, and required meetings.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, diet, fluids, medications, laboratory values, treatment adequacy, transplant awareness, and treatment modalities.
Provide safe hemodialysis care and accurately implement treatment prescriptions, including sodium and ultrafiltration modeling where appropriate.
Assess patient responses to treatment and modify care as indicated by the prescribing physician; communicate concerns and patient-related issues to the Team Leader or physician.
Initiate initial and annual nursing assessments and document ongoing patient care needs and evaluations.
Participate in pre-evaluation, treatment initiation, monitoring, termination, access homeostasis, and post-evaluation for hemodialysis patients.
Intervene when patient adequacy status changes or access flow problems are identified; provide, supervise when applicable, and monitor hemodialysis access care.
Administer and monitor prescribed interdialytic transfusions and report adverse reactions appropriately.
Ensure accurate and complete patient documentation, including treatment sheets, physician orders, treatment data, and medical information system entries.
Review and enter physician laboratory orders; prepare requisitions, confirm appropriate specimen tubes and processing, follow up on missed or insufficient specimens, package and route specimens appropriately, and report abnormal or alert results.
Enforce company policies and applicable state and federal regulations, and maintain safe, efficient, and effective shift operations.
Serve as a resource for staff and communicate with the Clinical Manager, physicians, and other health care team members to coordinate patient care.
Assist patients with prescription refills and coordinate patient transportation when necessary.
Maintain emergency procedure competency, initiate CPR and emergency measures when needed, and verify the availability of emergency equipment.
Ensure appropriate vaccinations, immunizations, and annual TB testing; administer prescribed or protocol-based medications and document their use and effectiveness.
Maintain controlled-substance records as required by law and maintain the facility drug list for required stock medications.
Ensure the treatment area is clean, safe, and sanitary; confirm stations, machines, and chairs are clean and properly placed; address blood spills according to policy.
Ensure patient admission, transfer, discharge, opening, and closing procedures are followed, including confirming staff and patients have safely left the premises.
Initiate, document, and complete ongoing CQI activities, including monthly reports, and complete monthly nurses' progress notes.
Review transplant status and follow established procedures for appropriate action.
Complete patient care plans for new patients within the initial 30 days and for unstable patients requiring monthly plans; complete due long-term programs.
Complete initial and annual Nursing History and Assessment physicals and annual standing order reviews with physicians.
Perform additional duties as assigned and provide coverage at area facilities as required by management.